NAR Association Health Plan Policy

Association Health Plans (AHP)

On June 21, 2018, the U.S. Department of Labor (DOL) issued a new rule opening the door for small employers and self-employed individuals, including real estate professionals, to participate in Association Health Plans (AHPs).

What is an AHP?

AHPs are "large group" plans that tend to offer better coverage options at lower cost than the "individual" and "small group" insurance markets. Currently many NAR members typically purchase their health coverage in the individual or small group markets, which tend to have higher costs and limited options.

What is NAR Doing?

NAR continues to evaluate whether and how AHPs can offer health insurance solutions to members and their families. NAR has conducted and will be conducting extensive research through surveys and nationwide focus groups. Additionally, NAR has retained outside health insurance consultants to develop channels of communication with large insurance companies pursuing AHPs and is working to better understand and secure favorable state regulatory environments. These efforts will continue, but the insurance companies have yet to show an appetite for offering a national AHP to NAR or any other trade association given the ongoing legal challenges and state regulatory barriers. There has been significant progress, but NAR still must take a number of concrete steps to find workable solutions.

Our Partners

A number of state and local REALTOR® associations have pursued health insurance solutions for members through AHPs and NAR continues to offer support for these programs. Check out NAR’s AHP Toolkit for these useful resources. Successful state and local implementation could serve as an example for insurers and could set the stage for a national plan down the road.

NAR also helped found a broad multi-industry to promote and preserve the DOL final rule – the Coalition to Protect and Promote AHPs. The purpose of the Coalition is to unite industry efforts and work with federal and state regulators to address state concerns while preserving the flexibility under the rule.

As part of the coalition and on an individual basis, NAR will continue to advocate for expanding our membership’s access to comprehensive and quality health insurance options at the federal, regional, state, and local levels.

Legal Challenges

Shortly after the DOL issued the AHP rule, more than a dozen states filed suit to overturn the rule. Many of the states also issued conflicting legal guidance. This combination has created uncertainty for insurance providers.

On March 28, 2019, the U.S. District Court for the District of Columbia held in favor of the AGs opposing the rule, striking down essential provisions allowing self-employed individuals to participate in an AHP and prohibiting “unrelated” employers from banding together to sponsor an AHP. Learn more about the court decision.

On May 31, 2019, the Department of Justice filed an appeal in the case. Pending the outcome of the appeal, the Department of Labor has issued a series of “question and answer” guidance on the court ruling to address outstanding questions related to AHP operations.

Oral arguments in the case were held in November and a decision is expected in late winter or early spring.

Where Are We Now?

The uncertainty in the legal landscape has prevented, at this time, a national insurance provider from stepping forward to offer a nationwide AHP option to NAR or any national trade association. Until the legal uncertainty is dissipated by Federal courts, or more states issue rules providing market stability, insurance companies are unlikely to develop acceptable plans that would be an attractive option for members.

In the meantime, NAR continues met with the Department of Labor encouraging protection of important provisions in the AHP rule that gives members access to these more affordable options. NAR also urged the Secretary to collaborate with the Department of Health and Human Services to ensure that federal law should not preempt states making statutory changes to allow for AHPs while the federal litigation is resolved.

NAR also remains invested in state and local association efforts to pursue AHPs and has developed an AHP Toolkit of resources for Associations to use as they investigate and seek to implement an AHP in their area.